Symptom Relief for Terminal Illness

November 19th, 2009
Caring for a loved one.

Caring for a loved one.

If you are a caregiver, you may have had training in symptom relief for terminally ill patients. But, many family members now take care of their loved ones at home, and training may come through experience only. If you are one of those latter individuals, spend some time at the library, as many books about caregiving can be found on the book shelves. Also, calls to local hospice organizations or training programs offered by hospitals can help provide information as well.

Some basic information about symptom relief is listed below, and these solutions apply to any person at any age — even if they do not have a terminal illness. These problems may frighten a caregiver at first, but they are common problems, and solutions are available. Remember to rely on a trained hospice worker, a trusted nurse or a doctor for specific directions for your ‘patient’ before you take extreme measures.

Constipation: This is a common problem during the last stages of terminal illness, because the patient may not be physically active. Some solutions include increasing fiber in the diet with foods such as prune juice and bran cereal. Sufficient fluids also help to resolve the problem in many instances. Only give stool softeners or laxatives as a doctor may recommend. He or she may recommend them, as constipation can be a side effect of some medications. The warning sign for severe problems – one that warrants a call to the doctor – is constipation for more than three days or blood in the stool.

Eating and Drinking: Smaller and more frequent meals may resolve the eating problem. Some physical activity, if the patient can tolerate it, also helps stimulate appetite. Fluids are, sometimes, the most important issue. Dehydration can develop rapidly in people who do not drink enough fluids. Use a straw or offer ice chips to suck. Be aware that too many fluids also are dangerous and providing intravenous fluids to a person who is dying may result in respiratory distress. Follow a doctor’s instructions on how much food and fluid is ‘normal’ for your patient’s situation.

Breathing Problems: Breathing problems can occur during the final stage of any illness and may require oxygen. Another way to help open breathing passages is to elevate the head of the patient’s bed or to move the patient to a recliner. A doctor may prescribe small doses of liquid morphine or bronchodilator drugs. Follow orders for these prescriptions carefully. Opening a window on a mild day or running a fan in the patient’s room also can help improve air circulation.

Nausea and Vomiting: This problem may occur as a side effect of some medications or as a result of the disease. Do not force a nauseated person to eat. Use ice chips instead of drinking to help retain body fluids. Overt vomiting is an issue, however, as the patient may not be able to keep down medication. A doctor may order medication in suppository form if the patient continues to be nauseated.

Dry Mouth: A dry mouth can be caused by medication or by the disease or by a lack of fluids. Go by the doctor’s advice on the amount of fluids to provide, and if the patient continues to have dry mouth, contact the doctor. You may need to provide glycerin swabs or artificial saliva for the inside of the mouth and a lit coating of lip balm for dry or cracked lips.

Itching: Dry skin, a new reaction to a laundry product, medications or the disease may cause rashes, dry skin and discomfort. To stop the itching, you can apply a soothing  skin cream (alcohol-free, as alcohol-based products can further dry the skin) or calamine lotion to itchy areas. Cornstarch, baking soda or baby powder may work, too. Use a humidifier during the fall and winter when heat is used to help moisten the air. You may need to experiment if none of this solutions work. Change laundry detergent or avoid dryer sheets to see if those solutions help.

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Depression, the Elderly and the Holidays

November 16th, 2009
A short visit to elderly neighbors can brighten everyone's holiday.

A short visit to elderly neighbors can brighten everyone's holiday.

If you are gathering steam to celebrate the holidays in grand style, you might consider visiting a neighbor or two in those plans. A visit to an elderly person, especially, during the holidays can lift everyone’s spirits well as provide the elderly person with a reason to avoid feeling isolated and depressed. These feelings often are more pronounced during traditional holiday festivities, especially if that elder has few social connections or family ties.

Older people who are at high risk for depression are those who are ill or disabled or who lack social contact and support. While few people would expect a neighbor to become involved with early signs of depression, a watchful eye on some obvious symptoms may help save an otherwise healthy elder from suicidal thoughts or actions. While you are not expected to become a caretaker in these situations, you might be surprised at how a relationship with your elderly neighbor can enhance your own life.

You can watch for the following symptoms of depression, which may include feelings of guilt or apathy, loss of self-esteem, difficulty concentrating, changes in appetite, weight loss or weight gain, difficulty sleeping, loss of interest in favorite activities and a pervasive feeling of sadness. It is easier to recognize these feelings in a loved one who is close to the family, but even neighbors can get a glimpse into an elder’s state of mind if that person mentions some of the difficulties in casual conversation. A simple mention of a lack of sleep and sloppy dress on a normally impeccable person may provide hints to a depressed state of mind.

Some people incorrectly assume that symptoms of depression in older people are a normal part of aging (as in the “Bah! Humbug!” syndrome). Others may assume that symptoms may relate to Alzheimer’s disease. Unlike Alzheimer’s disease, however, depression can be treated successfully with a combination of medications and/or therapy. Finally, there is a tendency to see the desire for privacy or solitude as symptoms of depression – some elderly people actually like the peace and quiet afforded by their solitude and don’t want to be annoyed by constant visits. Think long and hard, therefore, about bringing your kids around to visit with you, unless your elderly neighbor knows and enjoys your company as well as your kids’ presences.

This is why, as a neighbor, it is best to let the family handle any changes in your elderly neighbor’s behaviors. At the same time, they may not see their loved one as often as you do. In cases like this, it would not be out of line to offer the family assistance. Let them know you would be happy to contact them in emergency situations or if you see changes in your elderly neighbor’s behavior. If the family turns you down, at least you have offered your assistance. And, it doesn’t hurt to offer the same assistance to the elderly person, as that individual may take you up on your offer.

The holidays can make those symptoms of depression even more pronounced, but – sometimes – when the holidays pass, so do the symptoms. All it may take to help relieve those feelings of loneliness or sadness may be a visit to help decorate a door or to provide some canned goods or simply to say “hi.” You can easily bring some huge joy to someone with little effort on your part.

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Burn the Trash, Bury the Treasure?

November 14th, 2009

grave

I recently ran across several online documents produced by Orthodox Christians that objected to the practice of cremation. One, in particular, was written by Fr. John Touloumes and posted online in 2007. While is it ascertained in the beginning that the Orthodox Christian Church prohibits cremation, the document posted explains why.

The points from that document are as follows:

  • The document states that the practice of cremation is on the rise, partly due to the influence of Oriental religions and neo-paganism and buoyed by the erosion of the traditional beliefs among non-Orthodox Christians.
  • The Orthodox conviction that the Son of God was also truly Man and was raised in His whole human nature – body and soul – explains the Church’s traditional rejection of cremation, a practice which is diametrically opposed to the expectation of the resurrection of the dead in Christ.
  • Throughout church history and through the Resurrection, Jesus makes abundantly clear that the whole of our humanity – body as well as soul – has been called to salvation and eternal life.
  • The Church knows innumerable accounts of healing occurring upon being blessed with the relics of a saint. These men and women lived the life in Christ so fully that not only were their souls taken to heaven but their bodies retain the sanctity and healing power of the presence of the Holy Spirit.
  • The Church has unequivocally taught since Christ’s Crucifixion that the proper way to treat the dead is a reverent burial of the body in the context of a proper Church funeral and prayers for those who have fallen asleep in the Lord.

Finally, the article ends with this statement:

The Broad Picture Acceptance of cremation, therefore, would represent a radical departure from an established practice for which there seems to be no adequate reason to institute a change. The argument that cemeteries waste space does not stand in a nation as immense as our own, especially when the universality of modern transportation makes burial sites away from urban centers easily accessible. The sky-rocketing cost of burial is not seen at this time as a compelling reason to sanction cremation, for the Church does not ask that funerals be extravagant and costly, but that a certain amount of respect be maintained for the human body that was once the temple of a human soul. Thus the Church, due to a pastoral concern for the preservation of right beliefs and right practice within the Tradition of the Fathers, and out of a sense of reverence for its departed, must continue its opposition to this practice. Each Orthodox Christian should know that since cremation is prohibited by the canons [rules of the Church], those who insist on their own cremation will not be permitted a funeral in the Church. Naturally, an exception occurs when the Church is confronted with the case of some accident or natural disaster where cremation is necessary to guard the health of the living. In these special situations, the Church allows cremation of Orthodox people with prior episcopal permission and only by “economia.”

On the other hand, another religious leader questions embalming. While he states on the front end that “burial is far better, that cremation can send an unintended message that the body will not be resurrected, that it has Pagan origins, and that, by contrast, a body laid out in a casket is both a testimony of the law, and tangible evidence of the Gospel in the form of bodily resurrection,” embalming seems to shake this minister’s soul:

…one of my members (a former funeral director) threw me a curve-ball.

He argues that the modern method of embalming (which also has roots in Pagan Egypt) is itself a desecration. This is obviously something most of us never see. Blood is drained and thrown away. Parts of flesh even end up in the garbage. The body is filled with harsh chemicals. And all of this is to avoid the process of decomposition (Gen 3:19) that was spoken by God to Adam as part of the wages of sin.

His argument is that cremation – by avoiding the chemicals, the draining of fluids, the removal of flesh, and the mingling of the Christian’s flesh and blood with the garbage – is instead subjecting the body to a process that hastens the Gen 3:19 process, and is actually less of a desecration than embalming.

Be sure to read the comments posted below the second article as well as comments provided by readers who discuss cremation through any searches you might find when you look for “Orthodox Christian cremation.” You might discover that the arguments provided by the church may not seem popular, but they offer fodder for thought among readers. This is a good thing – for people to think about burial and what it means to their ideals and belief systems.

But, the church is not the only obstacle for those devout believers who also believe that cremation, when done with reverence, is an option for burial. In some cases, such as the one offered by Michigan funeral director, Thomas Lynch, in the book, Caring for the Dead: Your Final Act of Love, the funeral director might prove an obstacle. In that book, Lynch is noted for his “subtle and not-so-subtle disdain for those who opt for anything other than the elaborate, body-on-display funeral he unabashedly glorifies.” Cremation as a caring choice, according to author Lisa Carlson, is “beyond his bias to understand.”

His statement, which has been echoed by several church leaders over the past few years, clearly marks cremation is something that only the ‘unclean’ would choose when he stated, “We burned the trash and buried the treasure.”

How do you feel about this stance?

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Redefining Domestic Partnerships and Funeral Arrangements in Rhode Island

November 11th, 2009
Governor Donald Carcieri

Governor Donald Carcieri

The latest in deathcare news came today from Rhode Island, as that state’s Governor Don Carcieri vetoed a bill that would allow gays and lesbians in his state to plan funeral arrangements for their deceased partners. According to Governor Carcieri’s response [PDF] to that bill, he equated death care to marriage when he stated:

“…this bill represents a disturbing trend over the past few years of the incremental erosion of the principles surrounding traditional marriage, which is not the preferred way to approach this issue. If the General Assembly believes it would like to address the issue of domestic partnership, it should place the issue on the ballot and let the people of the State of Rhode Island decide.”

The bill in question for Governor Carcieri is 2009 S 0195 [PDF], an Act Relation to Businesses and Professions – Funeral Director/Embalmer Funeral Service Establishments, introduced by Senators Perry, Jabour, Miller, C Levesque and Pichardo. The bill, introduced in February this year, addresses domestic partners without stating sexual preferences of those partners. Instead, the definition is presented as:

…a person who, prior to the decedent’s death, was in an exclusive, intimate and committed relationship with the decedent, and who certifies by affidavit that their relationship met the following qualifications:

  1. Both partners were at least eighteen (18) years of age and were mentally competent to contract;
  2. Neither partner is married to anyone else;
  3. Partners were not related by blood to a degree which would prohibit marriage in the state of Rhode Island;
  4. Partners resided together and had resided together for at least one year at the time of death; and
  5. Partners were financially interdependent as evidenced by at least two (2) of the following:
    1. Domestic partnership agreement or relationship contract;
    2. Joint mortgage or joint ownership of primary residence;
    3. Two (2) of the following:
      • Joint ownership of motor vehicle;
      • Joint checking account;
      • Joint credit account;
      • Joint lease; and/or
        • The domestic partner had been designated as a beneficiary for the decedent’s will, retirement contract or life insurance.

How the governor read “gay” or “lesbian” into this agreement is bewildering, as our first thoughts were that many straight couples cannot meet the requirements for this agreement if they are residing together in a domestic partnership without marriage. But, he did, and his take on this definition for domestic partnerships reads:

“Notwithstanding the fact that there are a number of other sections in the Rhode Island General Laws that define a domestic partnership in the same manner, I believe the standard set forth deserves reconsideration by the General Assembly…A one (1) year time period for any relationship is not a sufficient length of duration to establish a serious, lasting bond between two (2) individuals to supplant the surviving individual over traditional family members relative to the sensitive personal traditions and issues regarding funeral arrangement, burial rights, and disposal of human remains. Many casual relationships last for longer than a year.”

While the Gay Rights blog at Change.org is in an uproar over this veto, heterosexual couples might take notice of this veto as well. While you may be residing in domestic partnership bliss, unknown circumstances can alter your lives forever. One way to avoid government interference into your funeral plans and to take care of your loved ones at the same time is to plan ahead for your funeral arrangements.

By planning ahead, you – and you alone – have control over your funeral options.

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Ten Warning Signs for Alzheimer’s Disease

November 9th, 2009
Learn the warning signs for Alzheimer's disease

Learn the warning signs for Alzheimer's disease

As many as 5.3 million Americans are living with Alzheimer’s disease. Alzheimer’s destroys brain cells, causing memory loss and problems with thinking and behavior severe enough to affect work, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. Today it is the seventh-leading cause of death in the United States.

How do you recognize the warning signs for this disease? The Alzheimer’s Association has prepared a list of common symptoms. If you make several marks on the list below, the person who has the symptoms should see a physician for a complete examination. Some of these symptoms may also apply to other forms of dementia:

  1. Recent memory loss that affects job skills: It’s normal to lose keys, to misplace a list or to forget a phone number – as long as you find the keys or the list or remember the phone number later. People who have dementia may forget things more often and not remember them later.
  2. Difficulty performing familiar tasks: You may have burned a dinner or forgot the popcorn in the microwave. Busy people can be distracted from time to time. People with Alzheimer’s disease could prepare a meal and forget not only to serve it but that they prepared it.
  3. Problems with language: Everyone has trouble finding the right word sometimes, but a person who has Alzheimer’s disease may forget simple words or substitute inappropriate words to form an incomprehensible sentence.
  4. Disorientation of time and place: If you’ve ever forgotten the day of the week, your age or your destination, you know that if you concentrate you find the solution immediately. Alzheimer’s disease may prevent people from remembering where they are, how they got there or how to get home. Sometimes, an Alzheimer’s patient may not know he or she is lost.
  5. Poor or decreased judgment: People with Alzheimer’s disease may forget about a child under their care or dress inappropriately, such as wearing an overcoat on a hot day or wearing several shirts or blouses at one time.
  6. Problems with abstract thinking: You may never be able to balance your checkbook, but you usually do not forget what numbers mean and how to use them. Alzheimer’s disease can prevent a person from remembering what numbers mean and what needs to be done with them.
  7. Misplacing things: While you still may not find your keys, you usually do not put an iron in the freezer or a necklace in the sugar bowl. Alzheimer’s disease can make a person forgetful, and it also can push a person to make inappropriate choices.
  8. Changes in mood or behavior: Sadness and moodiness can be a part of life. A person with Alzheimer’s disease, however, can experience rapid and extreme mood swings for no apparent reason.
  9. Changes in personality: As people age, their personalities often change depending upon experiences and beliefs. A person with Alzheimer’s disease can change personality drastically and seemingly without warning, becoming fearful, suspicious or confused.
  10. Loss of initiative: You’ve probably experienced depression in your lifetime, where you cannot become enthused about anything. Usually, with help or with a more positive attitude, these moods can dissipate. A person with Alzheimer’s however, may become very passive for long periods of time and require cues or prompting to become involved.

If you feel you or a loved one is exhibiting these signs, check with the Alzheimer’s Association to learn more about this disease. No two people experience Alzheimer’s disease or aging in the same way, so make sure that your perceptions are correct before you become overly concerned or depressed about your findings. A doctor also can help dispel or confirm your personal diagnosis and help you to plan ahead if you do have this disease.

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Thinking About Death May Change Your Life

November 6th, 2009
Facing the reality of death may bring serenity to your life.

Facing the reality of death may bring serenity to your life.

Have you faced the reality that, one day, you will die? If you haven’t faced this fact, don’t feel alone. Denial of death is a popular pastime in developed countries, as people don’t want to die any more than they want to pay taxes.

But, if you take the time to realize that you will die one day, your outlook on life may change and you may experience serenity. People who believe they will live forever (including many teens), often take more risks and make decisions that may take longer to resolve. The resulting chaos can be used as a means to avoid deep introspection, a skill that takes time to develop in many people.

One way to build that skill is to take life slowly and deal with situations as they arise. The person who tries to deal with situations or events that have not yet arisen and that may never arise can feel overwhelmed. This type of thinking also wears on a person’s health. Worrying about “what if” situations can become an addictive behavior, especially when an individual begins to think about his or her death.

Before you work yourself into a depression while thinking about life ending in death, think about a person who has been diagnosed with a terminal illness. Unfortunately, in many cases, a terminally ill person feels isolated and rightly so – the fact that many people do not want to face death in this society tends to spill over into real life as people avoid terminally ill loved ones.

But, dying is not a contagious disease. It is a fact of life. Still, many people treat death and dying with a hands-off attitude, mainly from fear. Many people equate death with pain, but physical pain can be endured or treated. Emotional pain often is the issue here. Fear of separation, fear of abandonment and fear of the unknown are real fears. These fears can be diminished by talking about them with a counselor or with your family and friends.

Alcoholics Anonymous deals with these fears in a twelve-step program [PDF] that addresses emotional issues and day-to-day activities that can prevent serenity. Since alcoholism is seen as a terminal illness among many recovering alcoholics, the individuals who seek treatment for their alcoholism (or drug abuse) can walk away with skills that can help many other people learn how to deal with life and death.*

Outside the twelve-step program, life plans also can be simplified further into four basic categories (not listed in any particular order):

  • Relationships with family members and friends
  • Job or career goals
  • Health issues
  • Spiritual questions

Taking each one of the four issues listed above, you can list obstacles that exist for you in any area within that category. Ask yourself questions such as:

  • Do any of my past relationships remain unresolved?
  • Do I have financial problems to address?
  • Do I exercise enough or can I eliminate foods that are not good for me?
  • What do I believe, and can I find support for my beliefs or do I need to change that perspective to find peace?

Although you deal with these four issues continuously throughout life, the answers to your questions may change as you age. The analogy would be like a movie you watched ten years ago or a book you read when you were younger. If you watched that movie or read that book again, you might see the content differently than you did ten years prior. AA calls this practice “taking inventory.” The average person might call it, “taking stock.” No matter what you call this personal interrogation, a constant desire to seek answers to life’s current dilemmas can help you to understand yourself and your loved ones better.

This willingness to take stock and to understand shifts in your perspective may show that you have grown emotionally, spiritually and in knowledge.

To realistically plan for your life to end one day is a practical exercise, and one that many hospices employ in their care-giving. But, if you think about the end of life now, rather than waiting for a time when you face death head-on, your willingness can present new opportunities rather than close doors. Facing the reality that life ends in death, always, may help you avoid chaos and worry and live a more peaceful life filled with satisfying relationships and goals.

*Note: Many addiction programs allow recovering addicts to replace “God” with “higher power” to help avoid resistance to recovery.

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Your Caregiver’s Bill of Rights

November 4th, 2009
Caregivers come in all genders, ages and races - and, they all have rights.

Caregivers come in all genders, ages and races - and, they all have rights.

Do you provide care for elderly or terminally ill individuals? You might volunteer for a hospice or you may be tending a loved one at home. In any situation where care is provided for a person’s physical or emotional needs, the caregiver may often feel overwhelmed and need help as well.

It’s difficult to pinpoint the origin of the caregiver’s “Bill of Rights,” but one copy of the list below was discovered in the book, Care for the Caregiver, sponsored by Parke-Davis and focused on Alzheimer’s Disease. This book, published in 1994, also provided information to caregivers about the disease and the theories behind its development.

We doubt that the list below originated with that book, but the point is that the Caregiver’s Bill of Rights has been around for at least two decades. Now, it is provided to readers across the Web on various hospice and caregiver sites. Some sites advocate that caregivers also join a support group – especially adult children who care for parents – to help face grief and to deal with stress. Support always is a great idea, no matter if you’re a caregiver at home or in a hospice.

While caregivers face seemingly insurmountable obstacles at times, caregiving also can bring families and friends closer together. We hope you can use the caregiver’s Bill of Rights below to help provide a guideline for building your life in a constructive and healthy way while providing care and solace to your loved ones and patients. You have the right:

  1. To take care of yourself. Caregiving is not an act of selfishness. It will give you the capability of taking better care of your loved one.
  2. To seek help from others even though your loved ones may object. Only you can recognize the limits of your endurance and strength.
  3. To maintain facets of your own life that do not include the person you care for, just as you would if he or she were healthy. You know that you do everything that you reasonably can for this person, and you have the right to do some things just for yourself.
  4. To get angry, be depressed, and express other difficult feelings occasionally.
  5. To reject any attempts by your loved one (either conscious or unconscious) to manipulate you through guilt, and/or depression.
  6. To receive consideration, affection, forgiveness, and acceptance for what you do, from your loved ones, for as long as you offer these qualities in return.
  7. To take pride in what you are accomplishing and to applaud the courage it has sometimes taken to meet the needs of your loved one.
  8. To protect your individuality and your right to make a life for yourself that will sustain you in the time when your loved one no longer need your full-time help.
  9. To expect and demand that as new strides are made in finding resources to aid physically- and mentally-impaired persons in our country, similar strides will be made towards aiding and supporting caregivers.

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From Cradle to Grave: WalMart’s Caskets

November 2nd, 2009
Walmart Caskets

Walmart Caskets

Walmart always had an eye for growth. Before Walmart opened in 1962, Sam Walton traveled the country to learn everything he could learn about discount retailing. Within a decade, Walton had fifteen Walmart stores and the chain went public, offering stock for the first time on the New York Stock Exchange in 1972.

That capital infusion allowed Walton to grow to 276 stores in eleven states by 1980. In 1983, the first Sam’s Club members-only warehouse opened and in 1988, the first Walmart Supercenter opened. By 1989, customers could shop at over 1,402 Walmart stores and 123 Sam’s Club locations. Sales increased from $1 billion in 1980 to $26 billion by 1989.

Today, with over 8,000 stores and club location in fourteen markets that server more than 176 million customers per year, Walmart has grown to represent the lives of many baby boomers as well as X and Y generations. When a customer walks into a WalMart store today, he or she can purchase any item for any of life’s needs and desires from diapers to caskets.

Caskets?

Yes, caskets. Walmart has created a beta site that currently offers a range of a little over a dozen casket styles and prices. You can choose from among the Regal Wide Body Steel Casket that is four inches wider than standard-sized caskets for about $1,200. You can choose the Lady de Guadalupe Steel Casket for just $895. Or, you can go all out for the Sienna Bronze Casket with hand-crafted brushed-finished highlights and hand-sewn velvet interior. This is the highest-priced casket at the moment, going for $2,899.00.

For opponents who contest Walmart’s sources for merchandise, those advocates for ‘made in the U.S.A’ materials can rest easy. All Walmart caskets currently are made and assembled in America. And, while caskets are not carried in stores, the shipping costs are reasonable. You can ship the casket straight to the funeral home if needed immediately, or store it in the attic as an hedge against future inflation.

In his autobiography, Walton wrote, “…if you think about it from the point of view of the customer, you want everything: a wide assortment of quality merchandise; the lowest possible prices; guaranteed satisfaction; friendly, knowledgeable service; convenient hours; and a pleasant shopping experience.”

Now, a Walmart customer can experience it all, from diapers to wedding rings to more diapers and, finally, caskets. A true birth-to-death experience, all under one roof.

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Coming to Terms with Fatal Disease: Talking with your Doctor

October 30th, 2009
The Doctor by Luke Fildes

The Doctor by Luke Fildes

If you do not die suddenly from an accident, heart attack or stroke, chances are you will die a slow death from disease or simply from aging. Unfortunately, in the latter case, doctors are well trained in every possible aspect of saving a life, but little on how to treat death and dying. So, if you are diagnosed with a fatal or chronic condition, how do you talk with your doctor effectively?

When you are diagnosed with a fatal illness or chronic condition, try to discover as much as possible about the medical facts about your condition. Most doctors are overworked, and many lack the skills to offer counseling for the emotional aspects of dealing with your illness. But, most doctors can provide facts about your condition. Additionally, you can use other resources, as noted below, to learn more about how to deal with your condition emotionally.

The following questions were gathered from Dr. Daniel R. Tobin’s book, Peaceful Dying, a step-by-step guide to preserving dignity, your choices and your inner peace in death and dying. These questions were designed to get as much information from your doctor about your condition as possible:

  • What are my treatment options?
  • What is my prognosis?
  • How long do you think I have to live? (while there is no surefire way for a doctor to predicit how long you’ll live, you can get a general idea of the life span of most people at your stage of disease)
  • What are the side effects of the treatments you are suggesting?
  • How much time do I have to make up my mind about which treatments to use? How will that time affect my treatment?
  • What treatments exist outside those offered by traditional Western medicine and where can I research such alternatives? (most doctors do not know much about alternatives, so you may have to search a little further to find answers to this questions)

Some tools you can use to find more answers include:

  • Get a second opinion and answers to your questions above.
  • Read more about your disease in books (written within the past five to ten years for the most updated information).
  • Join support groups for patients with your disease, and encourage your family members to do the same.
  • Surf the Internet for more information about your disease and treatments for that disease.
  • Seek counseling if needed with a specialist who understands grief, death and dying. This counseling can be invaluable for both you and your family.

When you are diagnosed with a fatal or chronic disease initially, the information you gather may be far different than information available to you as your disease progresses. Be sure to stay on top of new developments in your disease, as you never know when something might occur that either could ease your suffering or prolong your life.

In other words, while your doctor may be the best expert in his field, he may not know all the answers to your particular situation. You are responsible for your life and your death in many cases. So, take charge and live your life with dignity.

On a final note, sometimes diseases come on quickly and can incapacitate you without warning. Therefore, it might be wise to share this information with your family so that sharing in the responsibility becomes a family affair. When family members understand how to recognize and help treat H1N1, for instance, that knowledge may help to save a family member’s life.

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Tips for Taking Care of Prescriptions for Elderly

October 28th, 2009
Pills that are different colors can be helpful in organizing medications.

Pills that are different colors can be helpful in organizing medications.

Are you helping to take care of an elderly person? Many older people must take several different prescription and nonprescription drugs every day. Because these drugs often are taken during different times of the day, it can become easy for an elderly person (or even a stressed younger person) to become confused about which medication to take at what time.

This confusion can create a situation where an individual may skip a dose or overdose on a particular drug. The following tips can help alleviate some of these issues and more, and can help your loved one manage his or her medications as easily as possible.

  1. Make a list of all medications, including over-the-counter drugs, that the person is taking and keep it up to date. This list is useful both for the patient and for that patient’s doctor.
  2. Keep a medication schedule in the form of a calendar and check off each dose as it is taken.
  3. If the person has trouble remembering to take medications, try associating doses with specific times of day, such as breakfast, lunch and dinner, or waking up or before going to bed.
  4. Use a divided container to prepare a person’s doses for an upcoming week. Containers designed for this purpose are inexpensive (often free) and found at local drugstores.
  5. Be sure that the person takes his or her medications as prescribed. For instance, some medications must be taken between meals, and others must be taken with food or before eating. See #3 to help with association for these medications.
  6. If the patient has problems digesting certain drugs, ask the doctor or pharmacist if other forms are available. In other words, a pill may be hard to swallow, but that pill may be available in liquid, too.
  7. Use containers with easy-open lids rather than child-resistant lids to ease opening the bottle for someone who might suffer from arthritis. These easy-open lids are perfectly appropriate when children no longer reside in the house.
  8. Never transfer drugs from one container to another unless that second container has been labeled appropriately.
  9. When you pick up medicine from the pharmacy, read the label to make sure you understand the dosage required and when that medicine should be taken. If you have questions, it’s easier to ask when you receive the medication than to call later.
  10. Avoid keeping medicines on a bedside table. More than one overdose has been attributed to patients taking drugs too often when he or she is not fully awake. Additionally, the possibility of taking the wrong medication increases in this situation.
  11. Keep medications up to date. If a medication is to be renewed, be sure to let the doctor or pharmacist know about a week before the expiration on the current bottle. This way, you can rest assured that the medication can be continued without a lapse due to holidays, running out at night, etc.
  12. Dispose of all unused and expired prescriptions properly. Unfortunately, disposing of pills and medicines down the drain can increase the chances that local water supplies become contaminated. Keep the medications in the bottles with lids on and dispose of the bottles in the trash. This latter solution is not the best one, but until these bottles and their medications can be disposed of in an environmentally-safe way, people have little choice in how to eliminate the medicines from the household.
  13. Make sure that all pills are accounted for and that the patient is 1) not taking medications that belong to others, and 2) that the patient is not giving away medications.

One way to help cut down on the number of prescriptions that a person might be taking is to ask the doctor or pharmacist if the medication can be combined. For instance, why take a cough medicine and a decongestant when both can be combined and purchased in one package? This type of packaging may save money as well as time, space and confusion.

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